The combination drug trimethoprim/sulfamethoxazole can cut the risk of recurrent urinary tract infections by up to 80 percent in children with vesicoureteral reflux, according to a study in the New England Journal of Medicine.
Vesicoureteral reflux is a developmental abnormality in one or both ureters that allows urine to flow backward from the bladder into the ureters. Between 30 and 40 percent of children with UTIs have VUR.
Researchers gathered data from more than 600 pediatric patients between the ages of 2 and 71 months from 19 clinical sites across the United States. Participants were given either the drug combination or the placebo. Researchers followed participants for two years to observe symptomatic recurrences. Secondary outcomes were renal scarring, failure of prophylaxis and antimicrobial resistance.
The risk of recurrent infection for children with VUR receiving the combination drug fell by 50 percent. Participants with VUR and bladder and bowel dysfunction experienced an 80 percent reduction in risk for recurrent infections.
The secondary outcomes were not significantly different.
Researchers concluded antimicrobial prophylaxis in the form of the trimethoprim/sulfamethoxazole combination drug substantially reduced the risk of UTI recurrence in pediatric patients but did not reduce the incidence of renal scarring.
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